John Stephen Shank, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11777 Issued in WV

Practice address

350 Fairview Heights Rd
Summersville, WV 26651

Phone

(304) 872-5090

Fax

(304) 872-0636

NPI assigned

Oct 14, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: sshank@yourcarecommunity.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• West Virginia Health Care Cooperative Inc

  • Critical Access Hospital
  • Summersville, WV
  • NPI 1043778319
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1306835152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1029",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266510139",
            "telephone_number": "304-872-5090",
            "fax_number": "304-872-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 FAIRVIEW HEIGHTS RD",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "26651",
            "telephone_number": "304-872-5090",
            "fax_number": "304-872-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANK",
        "first_name": "JOHN",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "11777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0055930000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "550775750",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshank148585@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "350 Fairview Heights Rd",
            "city": "Summersville",
            "state": "WV",
            "country_code": "US",
            "postal_code": "266519301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshank148585@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "350 Fairview Heights Rd",
            "city": "Summersville",
            "state": "WV",
            "country_code": "US",
            "postal_code": "266519301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Seneca Health Services, Inc.
• Seneca Health Services, Inc.
• Barbara Shafer
• Krishnajivan Chhabildas Shah, M.D.
• Crischelle L Shank, M.D.
• Heather N Sharp-Spinks, MSW, LICSW, CAC, CCS
• Clayton N Shaver, PRSS
• Angel M Shaw
• Kevin Dale Shears
• Breanna Marie Shelton

• Family Medicine Physician in Summersville, WV
• Providers in Summersville, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.